CARING NURSES, INC.
ROC HHRG
Patient: DELGADO, GLORIA- MR# 900010823
Chart: 2 Episode: 1
Patient Care Assistant: son is assisting with care.
Visit Date: 03/28/2026
Problems:
ACUTE, RESP FAILURE, O2 3L CONT., HTN, ANEMIA, PNA, DIALYSIS M-W-TH, ALL SAME PREVIOUS DX, BACK PAIN AND BIL. LOWER LEGS PAIN

Tests
CLOX:

03/28/2026
OASIS-D
Iwona Arusztowicz
Assessor
(M0030) Start of Care Date:
02/12/2026

(M1030) Therapies the patient receives at home: (Mark all that apply.)

(M1033) Therapies the patient receives at home: (Mark all that apply.).
3 - Multiple hospitalizations (2 or more) in the past 6 months
4 - Multiple emergency department visits (2 or more) in the past 6 months
5 - Decline in mental, emotional, or behavioral status in the past 3 months
6 - Reported or observed history of difficulty complying with any medical instructions (for example, medications, diet, exercise) in the past 3 months
7 - Currently taking 5 or more medications
8 - Currently reports exhaustion

(M1200) Vision (with corrective lenses if the patient usually wears them):

(M1242) Frequency of Pain Interfering with patient's activity or movement:

(M1400) When is the patient dyspneic or noticeably Short of Breath?
3 - With minimal exertion (e.g., while eating, talking, or performing other ADLs) or with agitation

(M1610) Urinary Incontinence or Urinary Catheter Presence:
1 - Patient is incontinent

(M1620) Bowel Incontinence Frequency:
2 - One to three times weekly

(M1630) Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within the last 14 days): a) was related to an inpatient facility stay, or b) necessitated a change in medical or treatment regimen?
0 - Patient does not have an ostomy for bowel elimination.
(M1800). Grooming: Current ability to tend safely to personal hygiene needs (specifically: washing face and hands, hair care, shaving or make up, teeth or denture care, or fingernail care).
2 - Someone must assist the patient to groom self.

(M1810) Current Ability to Dress Upper Body safely (with or without dressing aids) including undergarments, pullovers, front-opening shirts and blouses, managing zippers, buttons, and snaps:
2 - Someone must help the patient put on upper body clothing.

(M1820) Current Ability to Dress Lower Body safely (with or without dressing aids) including undergarments, slacks, socks or nylons, shoes:
3 - Patient depends entirely upon another person to dress lower body.

(M1830) Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing hands, and shampooing hair).
4 - Unable to use the shower or tub, but able to bathe self independently with or without the use of devices at the sink, in chair, or on commode.

(M1840) Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and transfer on and off toilet/commode.
2 - Unable to get to and from the toilet but is able to use a bedside commode (with or without assistance).

(M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.
2 - Able to bear weight and pivot during the transfer process but unable to transfer self.

(M1860) Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a wheelchair, once in a seated position, on a variety of surfaces.
3 - Able to walk only with the supervision or assistance of another person at all times.

(M2030) Management of Injectable Medications: Patient's current ability to prepare and take all prescribed injectable medications reliably and safely, including administration of correct dosage at the appropriate times/intervals. Excludes IV medications.
3 - Unable to take injectable medication unless administered by another person.

ROC Verbal Orders for Modification
03/28/2026
Skilled Nursing
2Week1
03/28/26 - 04/03/26
2
1Week2
04/04/26 - 04/12/26
2
Physical Therapy
GENERALIZED WEAKNESS, DIFF. WALKINGFOR HEP EVAL ONLY 		Maria Consolo
Added by: 03/30/26 03:46 PM
Eval
03/28/26 - 04/12/26
1
Home Health Aide April King
Added by: Cremson 03/31/26 12:36 PM
1Week2
03/28/26 - 04/10/26
2
Primary Care Physician DR. SON BUI
PECOS Enrolled
Physician Scheduled Visit 01/31/2026: DR. ROSE LEIH JUSAYAN
02/07/2026: DR. MINA KIM
Reported to: Juliet 03/30/2026 03:32 PM
Printed By/Date/Time: 04/06/2026 09:10 AM